Delayed fatal neurotoxicity in post CAR-T cell therapy for multiple myeloma, a case report - PubMed
7 hours ago
- #Multiple myeloma
- #CAR-T therapy
- #Neurotoxicity
- Case report of delayed fatal neurotoxicity post CAR-T cell therapy in a 61-year-old female with relapsed/refractory multiple myeloma (RRMM).
- Patient developed severe neurotoxicity 50 days after ciltacabtagene autoleucel infusion, progressing to grade 4 ICANS with confusion, lethargy, rigidity, and parkinsonian features.
- MRI showed symmetric T2/FLAIR hyperintensities in basal ganglia and brainstem, along with reactive pachymeningitis.
- Despite aggressive immunosuppression, the condition was refractory, leading to death on day 93.
- Autopsy revealed severe bilateral hippocampal sclerosis, diffuse gliosis, and microglial infiltration.
- Highlights the need for prolonged clinical vigilance and novel management strategies for late-onset neurotoxicity in CAR-T therapy.